Healthcare Provider Details

I. General information

NPI: 1518804392
Provider Name (Legal Business Name): DANIEL NELSON ZIGO PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 15TH AVE NW
ARDMORE OK
73401-1810
US

IV. Provider business mailing address

605 S 12TH AVE
MADILL OK
73446-3004
US

V. Phone/Fax

Practice location:
  • Phone: 580-238-4277
  • Fax:
Mailing address:
  • Phone: 580-677-1240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number228622
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: